A primary purpose of cancer surgery and surgical pathology is to remove tumor tissues. Complete removal of tumors and all tumor tissue is important. If a tumor is not completely removed, then a second surgery may be required. This produces unneeded patient anxiety and risk, delays the start of second stage therapies, and incurs additional financial costs.
In order to completely remove all tumor tissue, surgeons and pathologists work together during surgery to assess tumor margins such that no malignant cells remain in the wound bed. Tumor margins are the healthy tissue surrounding the tumor, more specifically, the distance between the tumor tissue and the edge of the surrounding tissue removed along with the tumor. Ideally, the margins are selected so that the risk of leaving tumor tissue within the patient is low.
Intraoperative pathology consultation guides the cancer surgeon during surgery to assess if the tumor and margin have not been completely excised. Current surgical pathology consultation relies on palpation, visualization, and anatomical features to select sampling areas for frozen section analysis, which is often limited to 20-30 minutes. Intraoperative pathology consultation starts with gross examination of the excised tissues to choose areas for sampling. This is followed by dissection, embedding, frozen sectioning, and staining of 5-μm slice sections of the excised tissue.
The limited surgical consultation timeframe allows only a small portion of the resected tissue to be interpreted by the pathologist. This time crunch can result in sampling errors which negatively impact the patient outcome.
There exists a need in the art for better intraoperative tumor tissue analysis.